This agreement is to collect nationally representative based data from health care providers on the provision of colonoscopy in both symptomatic and asymptomatic patients. Colonoscopy is a highly effective clinical preventive service delivered in a variety of ambulatory settings, including both hospital-based and free-standing. Most data on patterns of colorectal screening are self-reported and collected directly from patients;however, this approach limits the level of clinical detail attainable and is subject to reporting bias.